Comparative performance of the ahmed and vertucci systems in classifying mandibular premolar canal morphology: a Bayesian and information-theoretic analysis
This multinational cone-beam computed tomography (CBCT) study evaluated the root canal morphology of mandibular first premolars (M1Ps) from 21 countries and compared how well the Ahmed and Vertucci classification systems represented these patterns. A total of bilateral mandibular first premolars from eligible CBCT scans were assessed using both systems, and the data were analyzed with a hierarchical probabilistic approach to account for population and imaging-related variation. Across the overall dataset, a simple single-canal configuration was the dominant pattern, and this remained the most common finding in all populations despite limited but structured variation in less frequent subclasses. The Ahmed system classified all observed configurations, whereas the Vertucci system left approximately 10.2% of cases without an equivalent category. In addition, Ahmed preserved more anatomical detail, while Vertucci compressed several distinct configurations into broader groups. Demographic and imaging-related factors had modest effects, with voxel size showing the clearest technical influence on the detection of more complex patterns. Overall, M1P morphology showed a stable global pattern with secondary heterogeneity, and the Ahmed system provided a more complete and informative representation for CBCT-based morphology assessment across diverse populations.
Authors
- Anna Lehmann (ORCID: https://orcid.org/0000-0002-8951-4045)
- Paulo Palma
- David Donnermeyer (ORCID: https://orcid.org/0000-0001-7162-9795)
- Glynn Dale Buchanan (ORCID: https://orcid.org/0000-0003-2957-166X)
- Anja Ivica
- José Martín‐Cruces (ORCID: https://orcid.org/0000-0002-4496-6582)
- Güldane Mağat (ORCID: https://orcid.org/0000-0003-4418-174X)
- Surendar Sugumaran (ORCID: https://orcid.org/0000-0002-5338-7021)
- Wen Yi Lim (ORCID: https://orcid.org/0000-0002-9926-7922)
- Safaa Allawi (ORCID: https://orcid.org/0000-0002-5436-5297)
- Indira Tulegenova (ORCID: https://orcid.org/0000-0002-4342-2372)
- Martha Gallegos Intriago
- Rafael Fernández‐Grisales (ORCID: https://orcid.org/0000-0002-1431-8373)
- O.E. Bekjanova (ORCID: https://orcid.org/0000-0002-1686-1820)
- Nessrin Taha
- Fatma Pertek Hatipoğlu (ORCID: https://orcid.org/0000-0003-0307-3021)
- Rohan Jagtap (ORCID: https://orcid.org/0000-0002-9115-7235)
- Ömer Hatipoğlu
- Abdelrahman Hamouda
- Xenos Petridis
- Mehdi Rahimi
- Ahmed A. Madfa
- Mohmed Isaqali Karobari
Institutions
- University of Bern (CH)
- Poznan University of Medical Sciences (PL)
- The University of Sydney (AU)
- Central University of Ecuador (EC)
- Jordan University of Science and Technology (JO)
- Recep Tayyip Erdoğan University (TR)
- University of Zagreb (HR)
- Al-Azhar University (EG)
- Kazakh National Medical University (KZ)
- Universidade de Santiago de Compostela (ES)
- National and Kapodistrian University of Athens (GR)
- University of Münster (DE)
- Sydney Dental Hospital (AU)
- Thamar University (YE)
- University of Mississippi Medical Center (US)
- University of Puthisastra (KH)
- University of Ha'il (SA)
- Necmettin Erbakan University (TR)
- Comprehensive Cardiovascular (US)
- National Dental Centre of Singapore (SG)
- Clínica CES (CO)
- Tashkent Pediatric Medical Institute (UZ)
- University of Pretoria (ZA)
- University of Coimbra (PT)
- Saveetha University (IN)
- Damascus University (SY)
Publication Details
- Journal
- Scientific Reports
- Published
- 2026-06-13
- DOI
- https://doi.org/10.1038/s41598-026-52409-7
- Primary Topic
- Endodontics and Root Canal Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00